Did the Car Accident Really Cause the Injury?
6 Major Factors of Causation
Causation is an element in a personal injury case.  Insurance companies love to point the finger at everyone but themselves. They will search for any reason to argue that your car accident did not really cause the injury. Causation means the causing of an event. In a personal injury case, you must connect the dots between a careless act of one person and the injury of another.
#1 Mechanism of Injury
The first factor of causation that is considered is what is called mechanism of injury. What that means is that in any type of personal injury case there were forces that were involved in hurting this person. In a car accident, the key indicator of the mechanism of injury is typically property damage. For example, you can make an assumption in a car accident, where the forces are strong enough to damage property and likely injure a person inside of the vehicle.  For example, let’s say a truck runs into a small sedan and knocks it over on its end, completely smashing it in on every side. The truck had run a red light and struck the sedan while traveling at over 60 miles per hour and completely caves in the vehicle. It is a total loss and there is no way possible to ever repair that vehicle again and it was a new vehicle. It was worth over $20,000 and the damages were excessive. Well, if there were people in that car when that impact occurred, it is reasonable to assume that they might be hurt. Their bodies may have suffered injuries because of the mechanism of injury, the forces involved in that collision are enormous.
In contrast of that, if you have a case where, let’s say, that the victim is in a very large truck but the at-fault party is in a small sedan. The small sedan is slowing to stop behind the truck at a red light but doesn’t quite slow down quick enough and just barely taps the back of the truck with the sedan’s front bumper. In fact, the bump made contact so softly that no property damage is even visible to the eye. The car is taken to an auto body shop and the owners are told that there is no damage. There was just a minuscule scrape that could be buffed out with a finger but it’s going to cost zero dollars in order to repair it. In those cases, the mechanism of injury is tiny. It’s very small, so you assume that the people in the vehicle are uninjured. This assumption seems likely, however, those assumptions can be wrong and often are.
Sometimes in big crashes people miraculously walk away unscathed. For whatever reason, they don’t suffer any type of injury or have any lingering issues from them and don’t require any medical treatment. But then sometimes, in relatively minor accidents, people do sustain injuries that cause them pain for prolonged periods of time. A lot of that depends on the condition of the person at the time of the accident.  Such as the way their body was positioned when the accident occurred as well as their age and physical fitness level. Also whether they were expecting the impact at the time of the crash and if they were wearing a seatbelt. All of these are factors that would affect how the impact affected them. There are all kinds of factors that can change the outcome.
#2 Egg-Shell Plaintiff
Another scenario that can change the outcome is the second factor of causation. It is something that is called the eggshell plaintiff rule. It is also known as the egg-shell skull rule. What that means is a tortfeaser, someone who commits a wrongful act that injures another person or the defendant in a personal injury case, has to accept the condition of the person that they injured at the time of the accident. What that means is if someone runs a red light and runs into a car, they don’t know when they make that careless mistake, whether the person they are about to strike is a very fit body builder with a clean bill of health who might be less likely to get hurt or not. They don’t know if it is an elderly woman who has had problems in the past with her neck. Maybe she had a fusion or some type of major surgery on her neck only a week ago and now even hitting her softly might rupture her fusion and cause her extreme amounts of pain and enormous medical bills in order to get her back to the condition that she was in prior to getting hit by the car. So that victim, the older woman in this scenario, is considered an eggshell plaintiff. Meaning that her body might be more susceptible to injury than somebody else that was in healthier condition. But that doesn’t mean that the negligent driver is off the hook and doesn’t have to pay for her medical bills and make her whole. In other words, the defending insurance company has to accept the condition of the victim as they find them.
#3 Pre-existing Injury
The third factor in determining whether the car accident caused the injury is something called pre-existing injuries. This is a major factor in auto accident cases.  Eggshell plaintiffs, or fragile plaintiffs, that are susceptible to injury, are often times that way because they have pre-existing injuries. This is not always the case, but often it is. If their low back has been bothering them for years, it is likely that if you hit them their low back is going to get worse because they already have a problem there. Those pre-existing conditons can become huge battle grounds because an insurance company might argue that, “Well, their back hurt before the crash and then our client hit them and his back still hurt. Therefore our client didn’t cause the injury, therefore we don’t owe them any money.”
But on the other hand, a personal injury attorney that is arguing for the victim’s side and trying to protect their rights will argue that because this person had pre-existing low back pain, their back was susceptible to injury. They were an eggshell plaintiff under Utah law and by hitting them, their back injury was actually aggravated or exacerbated in some way. Their injury was made worse, therefore you did cause their medical condition to become more serious and you are responsible to make them whole.  With this factor of causation, their injury was, in fact, caused by this accident.
Now this often hinges on two things. These two things are whether they have no case because of a previous injury or they do have a case because they are considered an eggshell plaintiff. The biggest factor there is, was there ever a period of being asymptomatic (not exhibiting symptoms)? The victim could be a person who has maybe had a back problem in their past but for the last two years before the car accident they have had zero problems. No pain and no medical care. They are fine. Whatever stuff was in their past is in their past. They are doing better but they might still be susceptible. They were asymptomatic but susceptible and when they got hit, their old injuries may have flared up and become much worse and are now causing them serious amounts of pain. That person would be compensated or should be compensated under the law.
Whereas the opposite of that would be someone who is having active symptoms immediately prior to the crash. They were already receiving medical care. Now those people, if the new injury from the crash makes their symptoms worse, are entitled to recover expenses and damages for the amount that their condition was exacerbated.   However not for the full amount of their pain, because they already had pain, but just for the amount that the pain was made worse. Whereas if they were asymptomatic, the car accident would be the cause of all of their future care. Even if they have a history of previous problems in that same area. So as you can see, this type of factor of causation can be quite difficult to sort out. A claimant in this sort of case would certainly benefit from the experience of a qualified personal injury attorney. Determining causation is obviously a much more legally complex issue than is eluded to in this article.
#4 Other Events Before Your Crash
The fourth factor in determining whether the car accident caused the injury is to consider other events before your crash. Sometimes a pre-existing injury might not totally bar your case but if you are involved in a pre-existing car accident that may make things difficult. Let’s say that you are in one accident and then the next month you are in another one. If the first accident was a bigger crash and caused injury and then the second one was smaller, it’s going to make it more difficult to recover on the second case because the insurance company is going to point at the first case. They will claim that your injuries were pre-existing from the first accident if they can possibly prove that in fact is what happened.
#5 Other Events After Your Crash
The fifth factor in determining whether the car accident caused the injury is: other events after the crash. An example of this would be when a claimant is hurt in a car accident but then they participate in other activities that could potentially cause injury or harm. Perhaps they go boating and get on a tube and somebody whips them off the tube and they go crashing off the tube at a high speed. Their body is jarred violently and suddenly their injuries are much worse. Now the fact that this activity took place after the crash becomes a very relevant factor as far as the issue of causation in the personal injury case. The at-fault insurance company could claim that if the claimant was ever really hurt in the accident they would not have participated in such an activity. This may or may not be true but the fact remains that the severity of the injury and it’s causes will need to be sorted out.
#6 Gaps In Treatment
The sixth factor in determining whether the car accident caused the injury is: gaps in treatment. That is if you stop seeing a doctor. Let’s say that you see a doctor regularly to receive treatment for a few months after an auto accident and then you are feeling a bit better, not all the way better, but improved enough that you decide you just want to give your body some time to heal. So you take a break from seeing the doctor for a bit. The problem is, any gap in treatment, maybe for more than a month or two, causes the insurance companies to raise their eyebrows. They might question it and say, “Well, if this person was truly hurt, they would have continued to go to the doctor. They haven’t seen a doctor for several months and now they show back up at the doctor and they suddenly need an MRI or maybe even need surgery?” Well, sometimes waiting and giving your body some time is part of the natural progression of healing. Reasonable people might wait a little bit in between medical treatment as they try to figure out what is wrong with them and they try to get better with the most conservative, least invasive measures. However, when those gaps between medical treatment become too big, that’s when it comes back to bite you. It is called a gap in treatment and an insurance company will argue that any medical bills that were incurred after the gap were not caused by your car accident.
Those are the six factors of causation.  The first four factors that were discussed in this article are somewhat out of one’s control. They are just the circumstances at the time of the accident. The last two however, events after the accident and gaps in treatment, can be controlled by the injured party. If you are involved in an accident where you sustain an injury, it would be wise to avoid activities that may lead to further injury until your case is settled if at all possible. Also being aware that large gaps in receiving medical treatment could raise concerns will help you make informed decisions about when you see your doctor. Your attorney can help advise you in these areas.